Private Insurance Wins in Democrats’ First Try at Expanding Health Coverage


The stimulus package also subsidizes private health insurance premiums for newly unemployed workers. They typically have the opportunity to purchase their former employers’ health benefits through a federal program called COBRA, which can often be prohibitively expensive because the employer is no longer paying a share of the worker’s premium.

The legislation that the House passed would cover 85 percent of COBRA premiums through September. The Senate plans to bump up the amount to 100 percent, meaning the government would pay the full cost of premiums. The Joint Committee on Taxation estimates the more generous Senate version will cost $35 billion.

There is not yet an estimate of how many people would gain coverage under the Senate plan, but the Congressional Budget Office did estimate that the original House version would reach 2.2 million former workers.

These policies have moved forward easily and with little opposition. The health care industry has generally supported the changes because private health plans typically pay higher prices to doctors and hospitals. Democrats who support expanding public coverage generally describe these changes as low-hanging fruit — the changes they could accomplish quickly to expand coverage.

But some progressives have questioned the decision to route patients into private health plans, which will cost the government more because of the high prices they pay for care.

“I don’t think this was the most efficient way to do this,” said Pramila Jayapal, a Democratic congresswoman from Washington State, who is the lead sponsor of the House’s Medicare for All bill. She proposed legislation that would have allowed unemployed Americans transition to Medicare rather than staying on their former employers’ plans.

This did not move forward. Nor has a plan from Senators Tim Kaine and Michael Bennet to create a version of Medicare, which they call “Medicare X,” available to all Americans.


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